Laparoscopic minimally invasive surgery (MIS) has revolutionized surgical care, reducing trauma to the patient, decreasing the need for medication, and shortening recovery times. Robotic minimally invasive surgery offers advantages over traditional laparoscopic techniques, such as improved wrist-like maneuverability, stereoscopic video displays, and scaling of surgical gestures to increase precision. Despite these advantages, the application of robotic surgery is disproportionately limited to urologic procedures. The addition of tactile feedback will allow surgeons to manipulate tissue with reduced grip force, significantly reducing the probability of causing tissue damage and the fatigue that may occur in longer procedures, and accelerating its expansion into other minimally invasive specialties. Over the previous four years, our group at the UCLA Center for Advanced Surgical and Interventional Technology (CASIT) has developed a complete tactile feedback system1, including a balloon-based tactile display, pneumatic and electronic control systems, and a commercial force sensor modified into an array configuration. The system measures forces at the tips of a laparoscopic grasper and provides proportional forces to the fingertips of the operating surgeon. The system was integrated with the da Vinci Surgical system, and our group discovered for the first time that tactile feedback produced a significant reduction in grip forces during Fundamentals of Laparoscopic Surgery (FLS) training tasks without altering performance. The reduction in grip forces was from a known tissue-damaging range into a tissue-safe range.2 the objective of this NIH R21 proposal is to evaluate the benefit of tactile feedback in an in-vivo environment, by performing studies concerning grip force and training in a porcine model. It is hypothesized that the successful application of this tactile feedback system will result in reduced grip force and improved precision and control during surgical manipulation, thus resulting in reduced tissue damage and quicker task completion. [Added: Results from this proposal will provide information that is essential for design of the next generation of tip-mounted tactile sensors, which is critical for future improvements in sensor systems.] PUBLIC HEALTH RELEVANCE: Robotic surgery has been adopted for numerous surgical procedures. It is widely cited that one of the most significant technical disadvantages associated with robotic surgery is the complete lack of haptic feedback. The addition of tactile feedback to robotic surgical systems has the potential to improve the precision and control of existing robotic surgery procedures, to reduce the occurrence of tissue damage, and to reduce the fatigue associated with longer procedures. The improved control may also reduce the learning curve associated with robotic surgery, and facilitate its expansion to a wider range of procedures.